JAMA Netw Open

Fewer than 1 in 4 adults stay on GLP-1 therapy at 12 months, study finds

March 12, 2026

A large retrospective cohort study of 126,984 adults with overweight or obesity but without diabetes found that only 24.5% remained on any GLP‑1 receptor agonist (RA) at 12 months. Switching was common—20.6% of patients changed agents—and switchers demonstrated higher persistence (36.4% vs. 21.4%; P<.001) and better adherence (mean proportion of days covered, 63% vs. 52%; P<.001) than nonswitchers.

Among the 26,197 adults who switched, the most frequent transition was from liraglutide to semaglutide (24.4%). While most switchers (92.7%) changed medications only once, a small subset (7.3%) underwent multiple switches, such as progressing from liraglutide to semaglutide and then to tirzepatide. These patterns suggest that switching commonly reflects active therapy optimization, not treatment disengagement.

Clinical takeaway: Reframe GLP‑1 RA switching as part of ongoing care—review tolerability, cost, and coverage early, and adjust agents strategically to support long‑term obesity‑treatment success.

Source:

Xie L, et al. (2026, March 10). JAMA Netw Open. Glucagon-Like Peptide-1 Receptor Agonist Switching and Treatment Persistence in Adults Without Diabetes. https://pubmed.ncbi.nlm.nih.gov/41805958/